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1.
Pan Afr Med J ; 39(Suppl 1): 7, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34548899

RESUMO

Introduction: intussusception is the leading cause of bowel obstruction in infants and young children. We describe the epidemiology and diagnostic and treatment characteristics of intussusception among Togolese infants over a 4-year period. Methods: we implemented active surveillance among infants younger than 1 year of age admitted with intussusception from 2015 to 2018 at Sylvanus Olympio Teaching Hospital and in 2018 at Campus Teaching Hospital. Brighton Collaboration Level 1 case definition criteria were used to confirm the diagnosis of intussusception. Results: during four years, 41 cases of intussusception, with an annual range of 8 to 14 cases (median: 10) were reported; and the highest number of cases (89%) was enrolled at Sylvanus Olympio teaching hospital. Intussusception was uncommon in the first 2 months of life, peaked from 5 to 7 months old (63%), with male predominance (63%), and showed no significant seasonality. One third of cases (34%) were transferred to the sentinel surveillance site from another health facility; and the median delay in seeking care was 4 days (range: 0-11) with ≥ 48-hour delay in 59% of cases. Clinical symptoms, ultrasound and surgery were combined to diagnose intussusception in all the cases (100%). The treatment was exclusively surgical, and intestinal resection was common (28/41, 68%). A high case fatality rate (23%) was observed and the average length of hospital stay was 10 days (range: 1-23). Conclusion: active surveillance for intussusception in Togo has highlighted exclusive use of surgical therapy; often associated to an intestinal resection with a very high case fatality rate.


Assuntos
Hospitalização/estatística & dados numéricos , Intussuscepção/epidemiologia , Conduta Expectante , Feminino , Hospitais de Ensino , Humanos , Lactente , Recém-Nascido , Intussuscepção/diagnóstico , Intussuscepção/cirurgia , Tempo de Internação/estatística & dados numéricos , Masculino , Vigilância de Evento Sentinela , Tempo para o Tratamento , Togo/epidemiologia
2.
BMC Infect Dis ; 21(1): 775, 2021 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-34372785

RESUMO

BACKGROUND: The aim of this study was to estimate the prevalence and factors associated with Trichomonas vaginalis (T. vaginalis) among female sex workers (FSW) in Togo in 2017. A cross-sectional bio-behavioral study was conducted from August to October 2017 using a respondent-driven sampling method in four cities in Togo. METHOD: A standardized questionnaire was used to record socio-demographic data and sexual behavior patterns. T. vaginalis detection by molecular biology tests was performed using Allplex STI Essential Assay which detect also 6 others micro-organisms. A blood sample was drawn and serological test using SD Bioline Duo VIH/Syphilis rapid test was performed for Human immunodeficiency virus (HIV) and syphilis testing. RESULTS: A total of 310 FSW with median age 25 years, interquartile range (IQR) [21-32 years] were included. The prevalence of T. vaginalis was 6.5% (95%CI = [4.1-9.9]) and, overall, prevalence of other STI ranged from 4.2% (95%CI = [2.3-7.2]) for N. gonorrhoeae to 10.6% (95% CI = [7.5-14.7]) for HIV. Binary logistic regression was conducted to assess factors associated with T. vaginalis infection. Living in Lomé (aOR = 3.19; 95%CI = [1.11-11.49]), having had sexual intercourse before the age of 18 (aOR = 5.72; 95%CI = [1.13-10.89]), and being infected with C. trachomatis (aOR = 3.74; 95%CI = [2.95-12.25]) were factors associated with T. vaginalis among FSW. CONCLUSION: The prevalence of T. vaginalis infection using molecular test was low among FSW in Togo. Extensive studies are needed to confirm and to better understand the epidemiology of T. vaginalis among this population and in other populations in Togo.


Assuntos
Infecções por HIV , Profissionais do Sexo , Doenças Sexualmente Transmissíveis , Vaginite por Trichomonas , Trichomonas vaginalis , Adulto , Estudos Transversais , Feminino , Infecções por HIV/epidemiologia , Humanos , Prevalência , Fatores de Risco , Doenças Sexualmente Transmissíveis/epidemiologia , Togo/epidemiologia , Vaginite por Trichomonas/epidemiologia , Trichomonas vaginalis/genética , Adulto Jovem
3.
Pan Afr Med J ; 38: 371, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34367450

RESUMO

Introduction: patellar instability is a rare multifactorial condition whose treatment is complex. The purpose of this study was to describe cases of patellar instabilities and then to assess treatment outcomes in low-income countries. Methods: the study was conducted from March 2013 to February 2018. Eight patients aged >15 years and who had undergone surgery for objective patellar instability were enrolled. Before and after surgery knee function was assessed using IKDC score. Results: the average age at surgery was 28.5 years and female sex was predominant (6 cases). Trochlear dysplasia was the main etiological factor (7 patients). In four cases dysplasia was related to patellar height (mean Caton index: 1.4). In five cases, section of lateral patellar retinaculum associated with TTA transposition and Insall's plasty was performed. Functional outcome was satisfactory, with a mean IKDC score of 91.3%. Conclusion: patellar instabilities are rare. Management is delayed in our developing countries, but outcomes are good when protocols are adapted.


Assuntos
Instabilidade Articular/cirurgia , Articulação do Joelho/cirurgia , Articulação Patelofemoral/cirurgia , Adolescente , Adulto , Feminino , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Togo , Resultado do Tratamento , Adulto Jovem
4.
BMC Health Serv Res ; 21(1): 882, 2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34452611

RESUMO

BACKGROUND: Cash transfer program during pandemics provide a social protection mechanism to improve the health of the most vulnerable households. This article analysis the impact of cash transfers on household demand for health care during Covid-19. METHODS: Using data from the survey conducted from 8th to 17th July 2020 covering all 44 districts in the 6 health regions of Togo under the direction of the United Nations Office for Project Services (UNOPS), we used propensity score matching and the ESR model. These models allow us to analysis the impact of cash transfers on health care use during Covid-19. RESULTS: Analysis of the results shows a positive impact of cash transfers on the use of health care services in Togo for beneficiary households. In addition, the health insurance promotes the use of health care among households' socio-economic factors. CONCLUSION: This cash transfer program is an effective approach to improving access to health care services for the most vulnerable households, particularly in the most disadvantaged settings. Thus, policy makers need to extend these cash transfers to a large part of the population during this Covid-19 health crisis as it has a positive impact on the demand for health care.


Assuntos
COVID-19 , Atenção à Saúde , Características da Família , Humanos , SARS-CoV-2 , Togo/epidemiologia
5.
BMJ Open ; 11(7): e045891, 2021 07 30.
Artigo em Inglês | MEDLINE | ID: mdl-34330852

RESUMO

OBJECTIVES: Improving access to emergency obstetrical and neonatal care (EmONC) is a key strategy for reducing maternal and neonatal mortality. Access is shaped by several factors, including service availability and geographical accessibility. In 2013, the Ministry of Health (MoH) of Togo used service availability and other criteria to designate particular facilities as EmONC facilities, facilitating efficient allocation of limited resources. In 2018, the MoH further revised and rationalised this health facility network by applying an innovative methodology using health facility characteristics and geographical accessibility modelling to optimise timely access to EmONC services. This study compares the geographical accessibility of the network established in 2013 and the smaller network developed in 2018. DESIGN: We used data regarding travel modes and speeds, geographical barriers and topographical and urban constraints, to estimate travel times to the nearest EmONC facilities. We compared the EmONC network of 109 facilities established in 2013 with the one composed of 73 facilities established in 2018, using three travel scenarios (walking and motorised, motorcycle-taxi and walking-only). RESULTS: When walking and motorised travel is considered, the 2013 EmONC network covers 81% and 96.6% of the population at the 1-hour and 2-hour limit, respectively. These figures are slightly higher when motorcycle-taxis are considered (82.8% and 98%), and decreased to 34.7% and 52.3% for the walking-only scenario. The 2018 prioritised EmONC network covers 78.3% (1-hour) and 95.5% (2-hour) of the population for the walking and motorised scenario. CONCLUSIONS: By factoring in geographical accessibility modelling to our iterative EmONC prioritisation process, the MoH was able to decrease the designated number of EmONC facilities in Togo by about 30%, while still ensuring that a high proportion of the population has timely access to these services. However, the physical access to EmONC for women unable to afford motorised transport remains inequitable.


Assuntos
Serviços Médicos de Emergência , Obstetrícia , Feminino , Instalações de Saúde , Acesso aos Serviços de Saúde , Humanos , Recém-Nascido , Togo
6.
BMC Public Health ; 21(1): 951, 2021 05 20.
Artigo em Inglês | MEDLINE | ID: mdl-34016072

RESUMO

BACKGROUND: The heavy and ever rising burden of non-communicable diseases (NCDs) in low- and middle-income countries (LMICs) warrants interventions to reduce their underlying risk factors, which are often linked to lifestyles. To effectively supplement nationwide policies with targeted interventions, it is important to know how these risk factors are distributed across socioeconomic segments of populations in LMICs. This study quantifies the prevalence and socioeconomic inequalities in lifestyle risk factors in LMICs, to identify policy priorities conducive to the Sustainable Development Goal of a one third reduction in deaths from NCDs by 2030. METHODS: Data from 1,278,624 adult respondents to Demographic & Health Surveys across 22 LMICs between 2013 and 2018 are used to estimate crude prevalence rates and socioeconomic inequalities in tobacco use, overweight, harmful alcohol use and the clustering of these three in a household. Inequalities are measured by a concentration index and correlated with the percentage of GDP spent on health. We estimate a multilevel model to examine associations of individual characteristics with the different lifestyle risk factors. RESULTS: The prevalence of tobacco use among men ranges from 59.6% (Armenia) to 6.6% (Nigeria). The highest level of overweight among women is 83.7% (Egypt) while this is less than 12% in Burundi, Chad and Timor-Leste. 82.5% of women in Burundi report that their partner is "often or sometimes drunk" compared to 1.3% in Gambia. Tobacco use is concentrated among the poor, except for the low share of men smoking in Nigeria. Overweight, however, is concentrated among the better off, especially in Tanzania and Zimbabwe (Erreygers Index (EI) 0.227 and 0.232). Harmful alcohol use is more concentrated among the better off in Nigeria (EI 0.127), while Chad, Rwanda and Togo show an unequal pro-poor distribution (EI respectively - 0.147, - 0.210, - 0.266). Cambodia exhibits the largest socioeconomic inequality in unhealthy household behaviour (EI - 0.253). The multilevel analyses confirm that in LMICs, tobacco and alcohol use are largely concentrated among the poor, while overweight is concentrated among the better-off. The associations between the share of GDP spent on health and the socioeconomical distribution of lifestyle factors are multidirectional. CONCLUSIONS: This study emphasizes the importance of lifestyle risk factors in LMICs and the socioeconomic variation therein. Given the different socioeconomic patterns in lifestyle risk factors - overweight patters in LMICs differ considerably from those in high income countries- tailored interventions towards specific high-risk populations are warranted to supplement nationwide policies.


Assuntos
Países em Desenvolvimento , Estilo de Vida , Adulto , Armênia , Burundi , Camboja , Chade , Egito , Feminino , Gâmbia , Humanos , Masculino , Nigéria , Prevalência , Fatores de Risco , Ruanda , Fatores Socioeconômicos , Tanzânia , Timor-Leste , Togo , Zimbábue
7.
BMC Public Health ; 21(1): 972, 2021 05 22.
Artigo em Inglês | MEDLINE | ID: mdl-34022820

RESUMO

BACKGROUND: Access to tailored HIV prevention services remains limited for West African MSM. We assessed adherence to quarterly HIV prevention services and its impact on HIV incidence in MSM followed up in four cities in Burkina Faso, Côte d'Ivoire, Mali, and Togo. METHODS: We performed a prospective cohort study between 2015 and 2018. HIV-negative MSM aged over 18 benefited from quarterly medical visits which included a clinical examination, HIV testing, screening and treatment for other sexually transmitted infections, peer-led counselling and support, and the provision of condoms and lubricants. Determinants of adherence to quarterly follow-up visits and incident HIV infections were identified using generalized estimating equation models and Cox proportional hazard models, respectively. RESULTS: 618 MSM were followed up for a median time of 20.0 months (interquartile range 15.2-26.3). Overall adherence to quarterly follow-up visits was 76.5% (95% confidence interval [CI] 75.1-77.8), ranging from 66.8% in Abidjan to 87.3% in Lomé (p < 0.001). 78 incident HIV infections occurred during a total follow-up time of 780.8 person-years, giving an overall incidence of 10.0 per 100 person-years (95% CI 8.0-12.5). Adherence to quarterly follow-up visits was not associated with the risk of incident HIV infection (adjusted hazard ratio 0.80, 95% CI 0.44-1.44, p = 0.545). CONCLUSIONS: Strengthening HIV prevention services among MSM in West Africa, including the use of PrEP, will be critical for controlling the epidemic, not only in this key population but also in the general population. Quarterly follow-up of MSM, which is essential for PrEP delivery, appears feasible. TRIAL REGISTRATION: ClinicalTrials.gov, number NCT02626286 (December 10, 2015).


Assuntos
Infecções por HIV , Minorias Sexuais e de Gênero , Idoso , Burkina Faso/epidemiologia , Costa do Marfim , França , Infecções por HIV/epidemiologia , Infecções por HIV/prevenção & controle , Homossexualidade Masculina , Humanos , Incidência , Masculino , Mali , Estudos Prospectivos , Togo
8.
Pan Afr Med J ; 38: 79, 2021.
Artigo em Francês | MEDLINE | ID: mdl-33889245

RESUMO

Introduction: congenital ocular anomalies are rare clinical entities. The purpose of this study is to describe the epidemiological and clinical features of congenital ocular anomalies at the University Hospital Campus in Lomé. Methods: we conducted a retrospective study at the Department of Ophthalmology of the University Hospital Campus in Lomé, over a 3-year period, from January 2016 to December 2018. It involved children with congenital ocular anomalies. The study variables were: sex; age at diagnosis; type of congenital ocular anomalies; laterality. Results: out of 2621 children assessed during the study period, 103 (3.9%) had congenital ocular anomalies. Of these, 60 (58.2%) were boys and 43 (41.8%) girls. The average age at diagnosis was 16 ± 5.2 months (ranging from 1 months to 5 years). The most common congenital ocular anomaly was cataract (53.4%). Unilateral alterations were predominant (56.3%). Congenital ocular anomalies were isolated (82.5%); associated with systemic anomalies (11.7%); associated with each other (5.8%). Conclusion: these results show that the epidemiological and clinical features of congenital ocular anomalies are similar to those reported in the literature. However, in our Hospital, the frequency of congenital ocular anomalies and patients' age at diagnosis are high. Early diagnosis is essential to ensure adequate management and preserve visual function.


Assuntos
Anormalidades do Olho/diagnóstico , Fatores Etários , Pré-Escolar , Anormalidades do Olho/epidemiologia , Anormalidades do Olho/fisiopatologia , Feminino , Hospitais Universitários , Humanos , Lactente , Masculino , Estudos Retrospectivos , Distribuição por Sexo , Togo
9.
J Econ Entomol ; 114(3): 1138-1144, 2021 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-33822089

RESUMO

The economic impact of the invasion of Spodoptera frugiperda (J.E. Smith, Lepidoptera: Noctuidae) into Africa has so far been limited to maize agriculture but could potentially impact many other crops. Trapping based on pheromone lures provides a cost-effective method for detecting this important pest (commonly known as fall armyworm) and will be essential for large-scale monitoring of populations to determine its geographical distribution and migration behavior as the species equilibrates to its new environment. However, the effective use of pheromone trapping requires optimization for a given location. An earlier report demonstrated that two commercial lures (one 3-component and the other 4-component) that were effective for trapping S. frugiperda in maize fields in Togo, Africa. The current study extends these findings to agricultural areas that differ in plant host composition (maize, pasture grasses, rice, and sorghum) in multiple locations in Ghana and Togo. In two seasons, significantly higher numbers of moths were found in maize, and in one season, higher numbers were found in rice than in sorghum and pasture grass systems. The results confirm the effectiveness of pheromone trapping and identify pheromone lures and trapping methods best suited for the different agroecosystems common to West Africa and that are at risk of infestation by S. frugiperda.


Assuntos
Mariposas , Animais , Ecossistema , Gana , Spodoptera , Togo , Zea mays
10.
Parasit Vectors ; 14(1): 134, 2021 Mar 02.
Artigo em Inglês | MEDLINE | ID: mdl-33653393

RESUMO

BACKGROUND: In March 2017, Togo was declared the first country in sub-Saharan Africa to eliminate lymphatic filariasis as a public health problem, but post-validation surveillance has been lacking. In some areas of the country, migrant groups from neighboring countries that are still endemic for LF pose a risk of reintroduction of LF to Togo. The objective of this study was to identify the risk posed by migrant groups by measuring their prevalence of LF infection and investigating any positive case using Togo's case investigation algorithm to prevent resurgence of LF and sustain Togo's elimination success. METHOD: A cross-sectional study was conducted in 2018 in the northernmost region of the country. Three migrant populations were identified: (i) nomadic Peuhls, (ii) Togolese members of local communities who migrate annually to neighboring countries for seasonal labor, and (iii) refugees from Ghana who came to Togo because of a communal conflict in Ghana. A questionnaire was designed to collect data on demographics and history of LF and MDA; all participants were tested for circulating filariasis antigen (CFA) using the filariasis test strip (FTS). Any CFA-positive case was confirmed with nocturnal microfilaremia. RESULTS: Refugees, seasonal economic migrants and nomadic Peuhls represented 42.1%, 31.4% and 26.5% of the study participants, respectively. The overall prevalence of CFA was 4.2% (58/1391) with the highest prevalence in the nomadic Peuhl group (11.9%), but only one of them (0.07%) was confirmed positive with nocturnal microfilaremia. Using the case investigation algorithm, no other positive case was identified in the positive case's surroundings. CONCLUSION: This study demonstrates that nomadic Peuhls, with a CFA prevalence of 11.9%, pose a potential risk for reintroduction of LF into Togo while Ghanaian refugees and seasonal economic migrants do not appear to pose a significant risk. Periodic monitoring of migrants, especially the nomadic Peuhl population, is a potential post-validation surveillance approach that could be used to promptly detect any LF cluster that may arise.


Assuntos
Filariose Linfática/epidemiologia , Monitoramento Epidemiológico , Saúde Pública , Migrantes/estatística & dados numéricos , Adolescente , Adulto , Animais , Criança , Pré-Escolar , Estudos Transversais , Filariose Linfática/tratamento farmacológico , Feminino , Filaricidas/uso terapêutico , Humanos , Lactente , Recém-Nascido , Masculino , Administração Massiva de Medicamentos , Pessoa de Meia-Idade , Prevalência , Togo/epidemiologia , Wuchereria bancrofti/isolamento & purificação , Adulto Jovem
11.
BMC Public Health ; 21(1): 575, 2021 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-33757471

RESUMO

BACKGROUND: Diarrhoea poses serious health problems among under-five children (U5C) in Low-and Medium-Income Countries (LMIC) with a higher prevalence in rural areas. A gap exists in knowledge on factors driving rural-non-rural inequalities in diarrhoea development among U5C in LMIC. This study investigates the magnitude of rural-non-rural inequalities in diarrhoea and the roles of individual-level and neighbourhood-level factors in explaining these inequalities. METHODS: Data of 796,150 U5C, from 63,378 neighbourhoods across 57 LMIC from the most recent Demographic and Health Survey (2010-2018) was analysed. The outcome variable was the recent experience of diarrhoea while independent variables consist of the individual- and neighbourhood-level factors. Data were analysed using multivariable Fairlie decomposition at p < 0.05 in Stata Version 16 while visualization was implemented in R Statistical Package. RESULTS: Two-thirds (68.0%) of the children are from rural areas. The overall prevalence of diarrhoea was 14.2, 14.6% vs 13.4% among rural and non-rural children respectively (p < 0.001). From the analysis, the following 20 countries showed a statistically significant pro-rural inequalities with higher odds of diarrhoea in rural areas than in nonrural areas at 5% alpha level: Albania (OR = 1.769; p = 0.001), Benin (OR = 1.209; p = 0.002), Burundi (OR = 1.399; p < 0.001), Cambodia (OR = 1.201; p < 0.031), Cameroon (OR = 1.377; p < 0.001), Comoros (OR = 1.266; p = 0.029), Egypt (OR = 1.331; p < 0.001), Honduras (OR = 1.127; p = 0.027), India (OR = 1.059; p < 0.001), Indonesia (OR = 1.219; p < 0.001), Liberia (OR = 1.158; p = 0.017), Mali (OR = 1.240; p = 0.001), Myanmar (OR = 1.422; p = 0.004), Namibia (OR = 1.451; p < 0.001), Nigeria (OR = 1.492; p < 0.001), Rwanda (OR = 1.261; p = 0.010), South Africa (OR = 1.420; p = 0.002), Togo (OR = 1.729; p < 0.001), Uganda (OR = 1.214; p < 0.001), and Yemen (OR = 1.249; p < 0.001); and pro-non-rural inequalities in 9 countries. Variations exist in factors associated with pro-rural inequalities across the 20 countries. Overall main contributors to pro-rural inequality were neighbourhood socioeconomic status, household wealth status, media access, toilet types, maternal age and education. CONCLUSIONS: The gaps in the odds of diarrhoea among rural children than nonrural children were explained by individual-level and neighbourhood-level factors. Sustainable intervention measures that are tailored to country-specific needs could offer a better approach to closing rural-non-rural gaps in having diarrhoea among U5C in LMIC.


Assuntos
Países em Desenvolvimento , Diarreia , Burundi , Camboja , Camarões , Pré-Escolar , Diarreia/epidemiologia , Egito , Feminino , Honduras , Humanos , Índia , Indonésia , Lactente , Libéria , Masculino , Mali , Mianmar , Namíbia , Nigéria , Ruanda , Fatores Socioeconômicos , África do Sul , Togo , Uganda , Iêmen
12.
BMC Infect Dis ; 21(1): 278, 2021 Mar 19.
Artigo em Inglês | MEDLINE | ID: mdl-33740909

RESUMO

BACKGROUND: The causative agent of cervical cancer referred to as Human papillomavirus (HPV) remains a real public health problem. Many countries in West Africa, such as Togo have no data on the high-risk HPV (HR-HPV) infection and genotypes distribution. In order to fill the knowledge gap in the field in Togo, the main objective of this study was to determine the prevalence of pre-cancerous lesions of the cervix and HR-HPV genotypes among Togolese women. METHODS: Samples were collected from 240 women by introducing a swab in the cervix. Then, the screening of precancerous cervical lesions using the visual inspection with acetic acid and lugol (VIA / VIL) was conducted. The HR-HPV genotypes were characterised by real-time multiplex PCR. RESULTS: Out of 240 women recruited, 128 (53.3%) were infected by HR-HPV. The most common genotypes were HPV 56 (22.7%), followed by HPV 51 (20.3%), HPV 31 (19.5%), HPV 52 (18.8%) and HPV 35 (17.2%). The least common genotypes were HPV 33 (2.3%) and HPV 16 (2.3%). Among the women, 1.3% (3/240) were positive to VIA/VIL. CONCLUSION: This study allowed HR-HPV genotypes to be characterised for the first time in Lomé, Togo. This will help in mapping the HR-HPV genotypes in West Africa.


Assuntos
Alphapapillomavirus/genética , Infecções por Papillomavirus/patologia , Adulto , Alphapapillomavirus/isolamento & purificação , Colo do Útero/virologia , Estudos Transversais , DNA Viral/genética , DNA Viral/metabolismo , Feminino , Genótipo , Humanos , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase Multiplex , Infecções por Papillomavirus/epidemiologia , Fatores de Risco , Togo/epidemiologia
13.
J Environ Manage ; 285: 112158, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33601260

RESUMO

Drought and soils poverty considerably decreased agriculture yields in Togo. In this context, the use of wastes' composts as organic amendments presents the advantages to increase crops' yields and improve the fertility of soils while valorizing wastes. However, the effects of wastes' composts on the growth of plants highly depend on their quality, specifically on their chemical properties and the organic matter maturity. In this study, three different wastes' composts were prepared by mixing household wastes and food wastes with admixtures as natural phosphate and manure. The composts produced were analyzed according to agronomic parameters before applying a leaching test to specially assess the organic matter maturity by considering its hydrophobic and aromatic characters. Whatever the compost, the contents in organic matter and nutrients were comparable to composts usually commercialized in Togo. Their characteristics depended on their initial chemical composition. The higher the food wastes percentage, the higher the organic matter content and the addition of admixtures considerably increased the percentages in nutrients in the final product. Besides, a slightly acidic pH, a high redox potential and a low aromatic and hydrophobic organic matter were recorded for compost of food wastes unlike household wastes and mixed composts and the highest concentrations in trace metals were quantified in compost of household wastes. Agronomic tests were performed on maize (Zea mays L.) under two water regimes to evaluate the impact of the characteristics of composts on both maize's nutrition and adaptation to water stress. The chemical characteristics of composts and the maturity of organic matter highly impacted the absorption of macronutrients by plants. A slightly acidic pH and a high redox potential improved the transfer of nutrients from soils to plants under normal irrigation conditions. On the contrary, a higher aromaticity of organic matter promoted the absorption of nutrients under water stress. Wastes' composts can thus be relevantly used to improve the nutrition of plants in function of the irrigation conditions.


Assuntos
Compostagem , Desidratação , Humanos , Nutrientes , Solo , Togo , Zea mays
14.
PLoS One ; 16(2): e0246151, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33529263

RESUMO

OBJECTIVES: This study aimed to describe HIV testing uptake, as well as HIV prevalence and its associated factors among older adults aged ≥50 years in health facilities in Togo. METHODS: A cross-sectional study was carried out from February 2018 to June 2019 among hospitalized older adults aged ≥50 years in tertiary and secondary hospitals in Togo. HIV testing was performed according to the national algorithm. Socio-demographic data and HIV testing history were collected using a standardized questionnaire. RESULTS: A total of 619 patients (43.9% female) of median age 61 years, (IQR: 55-70) were recruited and offered HIV testing. Among them, 25.7% had never previously tested for HIV. In total, 91.6% (567/619) accepted HIV testing while 8.4% (52/619) refused to be tested. Of those who tested, forty patients were HIV positive, yielding a prevalence of 7.1%. Twenty-three patients (57.5%) were newly diagnosed with HIV infection. In multivariable analysis, two factors were associated with HIV infection: living alone (aOR = 5.83; 95%CI = [2.26-14.53]) and being <60 years (aOR = 3.12; 95%CI = [1.51-6.66]). CONCLUSION: The majority of older adults in this study accepted testing for HIV and almost three in five HIV positive older adults were newly diagnosed with HIV as a result of this testing. There is an urgent need to integrate older adults into responses to the HIV epidemic and to strengthen targeted prevention care and treatment in this population.


Assuntos
Infecções por HIV/epidemiologia , Teste de HIV/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Idoso , Estudos Transversais , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Centros de Cuidados de Saúde Secundários , Centros de Atenção Terciária , Togo/epidemiologia
15.
Environ Manage ; 67(5): 949-962, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33566132

RESUMO

Climate change (CC) effects on agriculture development and households' vulnerability are widely recognized. Being aware of the induced effects of climatic risks, farmers have adopted adaptation strategies to build resilience. Analyzes the determinants of choice of adaptation strategies using binary models can lead to an estimation bias, since the number of adopted strategies may be correlated. This paper analyzes farm households' perception of CC, the determinants of choice of the number of adopted practices, and correlation between the most used climate-smart strategies in subsistence agriculture. Zero-inflated Poisson regression and multivariate analysis are employed using data collected from 704 farm households in Northern Togo. Households' minimum consumption needs, gender, land, access to credit and extension services are the main determinants of the choice of the number of adopted strategies. The use of resistance and high yielding varieties, crops and livestock integration, soil and water conservation practice, the use of organic fertilizer, and adjustment of sowing time are the most adopted farming practices. A strong complementarity between the adopted practices for agriculture development was found. Factors that influence households' choice of adaptation strategies include gender, household location, education level, family size, and allocated labor. Institutional factors including market access, access to credit, and extension services are also key determinants in promoting the use of climate-smart practices that are environmentally friendly.


Assuntos
Agricultura , Fazendeiros , Animais , Mudança Climática , Características da Família , Fazendas , Humanos , Togo
16.
Sci Rep ; 11(1): 1619, 2021 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-33452336

RESUMO

Numerous population-based studies have documented high prevalence of aflatoxin associated childhood stunting in low income countries. We provide an estimate of the disease burden of aflatoxin related stunting using data from the four African countries. For this empirical analysis, we obtained blood aflatoxin albumin adduct biomarker based exposure data as measured using ELISA technique and anthropometric measurement data from surveys done over a 12-year period from 2001 to 2012 in four low income countries in Africa. We used these data to calculate population attributable risk (PAR), life time disease burden for children under five by comparing two groups of stunted children using both prevalence and incidence-based approaches. We combined prevalence estimates with a disability weight, measuring childhood stunting and co-occurrence of stunting-underweight to produce years lived with disability. Using a previously reported mortality, years of life lost were estimated. We used probabilistic analysis to model these associations to estimate the disability-adjusted life-years (DALYs), and compared these with those given by the Institute for Health Metrics and Evaluation's Global Burden of Disease (GBD) 2016 study. The PAR increased from 3 to 36% for aflatoxin-related stunting and 14-50% for co-occurrence of stunting and underweight. Using prevalence-based approach, children with aflatoxin related stunting resulted in 48,965.20 (95% uncertainty interval (UI): 45,868.75-52,207.53) DALYs per 100,000 individuals. Children with co-occurrence of stunting and underweight due to exposure to aflatoxin resulted in 40,703.41 (95% UI: 38,041.57-43,517.89) DALYs per 100,000 individuals. Uncertainty analysis revealed that reducing aflatoxin exposure in high exposure areas upto non-detectable levels could save the stunting DALYs up to 50%. The burden of childhood all causes stunting is greater in countries with higher aflatoxin exposure such as Benin. In high exposure areas, these results might help guide research protocols and prioritisation efforts and focus aflatoxin exposure reduction. HEFCE Global Challenge Research Fund Aflatoxin project.


Assuntos
Aflatoxinas/efeitos adversos , Efeitos Psicossociais da Doença , Transtornos do Crescimento/patologia , Aflatoxinas/sangue , Albuminas , Benin , Pré-Escolar , Feminino , Gâmbia , Transtornos do Crescimento/economia , Transtornos do Crescimento/etiologia , Humanos , Lactente , Masculino , Anos de Vida Ajustados por Qualidade de Vida , Fatores de Risco , Tanzânia , Togo
17.
Malar J ; 20(1): 50, 2021 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-33472640

RESUMO

BACKGROUND: The use of rapid diagnostic tests (RDTs) to diagnose malaria is common in sub-Saharan African laboratories, remote primary health facilities and in the community. Currently, there is a lack of reliable methods to ascertain health worker competency to accurately use RDTs in the testing and diagnosis of malaria. Dried tube specimens (DTS) have been shown to be a consistent and useful method for quality control of malaria RDTs; however, its application in National Quality Management programmes has been limited. METHODS: A Plasmodium falciparum strain was grown in culture and harvested to create DTS of varying parasite density (0, 100, 200, 500 and 1000 parasites/µL). Using the dried tube specimens as quality control material, a proficiency testing (PT) programme was carried out in 80 representative health centres in Togo. Health worker competency for performing malaria RDTs was assessed using five blinded DTS samples, and the DTS were tested in the same manner as a patient sample would be tested by multiple testers per health centre. RESULTS: All the DTS with 100 parasites/µl and 50% of DTS with 200 parasites/µl were classified as non-reactive during the pre-PT quality control step. Therefore, data from these parasite densities were not analysed as part of the PT dataset. PT scores across all 80 facilities and 235 testers was 100% for 0 parasites/µl, 63% for 500 parasites/µl and 93% for 1000 parasites/µl. Overall, 59% of the 80 healthcare centres that participated in the PT programme received a score of 80% or higher on a set of 0, 500 and 1000 parasites/ µl DTS samples. Sixty percent of health workers at these centres recorded correct test results for all three samples. CONCLUSIONS: The use of DTS for a malaria PT programme was the first of its kind ever conducted in Togo. The ease of use and stability of the DTS illustrates that this type of samples can be considered for the assessment of staff competency. The implementation of quality management systems, refresher training and expanded PT at remote testing facilities are essential elements to improve the quality of malaria diagnosis.


Assuntos
Antígenos de Protozoários/análise , Técnicas e Procedimentos Diagnósticos/estatística & dados numéricos , Instalações de Saúde , Mão de Obra em Saúde/normas , Ensaio de Proficiência Laboratorial/normas , Malária Falciparum/diagnóstico , Plasmodium falciparum/química , Humanos , Ensaio de Proficiência Laboratorial/métodos , Controle de Qualidade , Manejo de Espécimes , Togo
18.
Parasit Vectors ; 14(1): 23, 2021 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-33407812

RESUMO

BACKGROUND: The World Health Organization has targeted lymphatic filariasis (LF) for elimination as a public health problem and recommends, among other measures, post-elimination surveillance of LF. The identification of sensitive and specific surveillance tools is therefore a research priority. The Wuchereria bancrofti-specific antigen Wb123-based enzyme-linked immunosorbent assay (Wb123 ELISA) detects antibodies to the recombinant Wb123 antigen of W. bancrofti and may be useful as a surveillance tool for LF. Six years after stopping mass drug administration to eliminate LF and recording successful results on two post-treatment transmission assessment surveys, a study was conducted in Togo aimed at helping to identify the role of the Wb123 ELISA in post-validation surveillance of LF. METHODS: This was a cross-sectional study in eight previously LF-endemic districts and one non-endemic district in Togo. In each sub-district of these nine districts, two schools were selected and 15 children aged 6 to 9 years old at each school provided finger-stick blood for testing for antibodies to Wb123 using the Filaria Detect™ IgG4 ELISA kit® (InBios, International, Inc., Seattle, WA, USA). RESULTS: A total of 2654 children aged 6 to 9 years old were tested in 134 schools in the nine districts. Overall, 4.7% (126/2654) children tested positive for antibodies to the Wb123 antigen of W. bancrofti. The prevalence of Wb123 antibodies varied across the eight previously endemic LF districts, from 1.56 to 6.62%. The highest prevalence, 6.99%, was found in the non-endemic district, but this was not significantly different from the average of all the LF districts (4.49%, P = 0.062). CONCLUSIONS: The Wb123 ELISA was positive in 4.7% of Togolese school-age children who were almost certainly unexposed to LF. This apparent lack of specificity in the Togo context makes it difficult to establish a seroprevalence threshold that could serve to signal LF resurgence in the country, precluding the use of this test for post-validation surveillance in Togo. There remains a need to develop a useful and reliable test for post-elimination surveillance for LF in humans.


Assuntos
Anticorpos Anti-Helmínticos/sangue , Filariose Linfática , Wuchereria bancrofti/imunologia , Animais , Antígenos de Helmintos/sangue , Criança , Estudos Transversais , Filariose Linfática/diagnóstico , Filariose Linfática/prevenção & controle , Monitoramento Epidemiológico , Feminino , Humanos , Masculino , Prevalência , Saúde Pública/estatística & dados numéricos , Estudos Soroepidemiológicos , Togo/epidemiologia
19.
BMC Cancer ; 21(1): 26, 2021 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-33402100

RESUMO

BACKGROUND: In people with albinism (PWA), the deficiency of melanin increase the risk of skin cancers. The aim of this study was to determine the prevalence of skin cancers and characteristics of these detected skin cancers (histological types, localization) in PWA in 10 cities in Togo in 2019. METHODS: This is a cross-sectional study of medical records of PWA systematically examined during two mobile skin care clinics in 2019, as part of a programme for the prevention and management of skin cancers in these subjects. RESULTS: During the study period, 280 (95.2%) of the 294 PWA consulted, had developed skin lesions. Of the 280 PWA, the pathological reports from the medical records of 33 patients (11.8%; (95%CI = [8.2-16.2]) had concluded to non-melanoma skin cancers. The mean age of these 33 patients was 38.6 ± 15.2 years and the sex-ratio was 1. Their occupations were mainly resellers (21.2%), traders (15.2%) and farmers (12.2%). In the 33 patients, 54 cases of non-melanoma skin cancers were identified, with some patients having more than one tumor, and some of them having more than one (histologically confirmed) diagnosis. These 54 non-melanoma skin cancers were divided into 21 cases of invasive squamous cell carcinomas, 2 cases of Bowen's disease and 31 cases of basal cell carcinomas. These non-melanoma skin cancers mainly occurred in the head and neck (33 cases; 61.1%), the upper limbs (15 cases; 27, 8%) and the trunk (4 cases; 7.4%). CONCLUSION: The results of this study show a high prevalence of skin cancers among PWAs in Togo in 2019, only non-melanoma skin cancers. In addition, they illustrate the role of ultraviolet rays with regard to the localization of skin cancers and the occupations of patients. Popularization and compliance with photo protection measures, systematic and regular examination of the skin of these PWAs will allow early detection and treatment of these skin cancers.


Assuntos
Albinismo/complicações , Carcinoma Basocelular/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Neoplasias Cutâneas/epidemiologia , Adolescente , Adulto , Idoso , Carcinoma Basocelular/etiologia , Carcinoma Basocelular/patologia , Carcinoma de Células Escamosas/etiologia , Carcinoma de Células Escamosas/patologia , Estudos Transversais , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Prognóstico , Higiene da Pele/métodos , Neoplasias Cutâneas/etiologia , Neoplasias Cutâneas/patologia , Togo/epidemiologia , Adulto Jovem
20.
Psychiatry Res ; 297: 113714, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33453497

RESUMO

OBJECTIVES: Currently, there is little data on the mental health consequences of the COVID-19 pandemic in low- and middle-income countries (LMICs). This study aims to examine the pooled and separate prevalence and determinants of depression during the pandemic in samples from four LMICs. METHODS: Participants (N= 1267, 40.9% women) were recruited from the Democratic Republic of the Congo (DRC), Haiti, Rwanda, and Togo. They completed an online cross-sectional survey on sociodemographics, exposure and stigmatization related to COVID-19, the Hopkins Symptom Checklist depression subscale, and the Connor-Davidson Resilience Scale-2. RESULTS: The pooled prevalence for depression symptoms was 24.3% (95% CI: 22.08-26.79%), with significant differences across countries. Younger age, gender (women), and high levels of exposure and stigmatization related to COVIID-19, and resilience were associated with depression in the pooled data. There were significant variations at the country level. Stigmatization (but not exposure to COVID-19 and resilience) was a strong predictor among the four countries. CONCLUSIONS: The prevalence of depression symptoms in the LMICs are similar to those reported in China and in most high-income countries during the pandemic. The findings emphasize the need for implementing non-fear-based education programs during epidemics to reduce stigmatization.


Assuntos
Ansiedade/epidemiologia , COVID-19/psicologia , Depressão/epidemiologia , SARS-CoV-2 , Estigma Social , Adulto , Ansiedade/psicologia , COVID-19/epidemiologia , Estudos Transversais , República Democrática do Congo/epidemiologia , Escolaridade , Feminino , Haiti/epidemiologia , Humanos , Renda , Masculino , Saúde Mental , Pessoa de Meia-Idade , Pandemias , Pobreza , Prevalência , Ruanda/epidemiologia , Estereotipagem , Togo , Adulto Jovem
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